|
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$91.50
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
6429
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$82.35 |
| Rate for Payer: Aetna American Axle |
$59.48
|
| Rate for Payer: Aetna American Axle |
$353.44
|
| Rate for Payer: Aetna American Axle |
$10.20
|
| Rate for Payer: Aetna American Axle |
$312.81
|
| Rate for Payer: Aetna American Axle |
$13.86
|
| Rate for Payer: Aetna American Axle |
$13.60
|
| Rate for Payer: Aetna American Axle |
$13.35
|
| Rate for Payer: Aetna American Axle |
$12.08
|
| Rate for Payer: Aetna American Axle |
$11.88
|
| Rate for Payer: Aetna Commercial |
$462.19
|
| Rate for Payer: Aetna Commercial |
$18.12
|
| Rate for Payer: Aetna Commercial |
$409.06
|
| Rate for Payer: Aetna Commercial |
$17.46
|
| Rate for Payer: Aetna Commercial |
$15.53
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$77.78
|
| Rate for Payer: Aetna Commercial |
$15.79
|
| Rate for Payer: Aetna Commercial |
$17.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.48
|
| Rate for Payer: Cash Price |
$385.00
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$16.74
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$14.86
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$435.00
|
| Rate for Payer: Cash Price |
$16.43
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Advantage |
$14.38
|
| Rate for Payer: Cofinity Advantage |
$14.64
|
| Rate for Payer: Cofinity Advantage |
$12.79
|
| Rate for Payer: Cofinity Advantage |
$64.05
|
| Rate for Payer: Cofinity Advantage |
$336.88
|
| Rate for Payer: Cofinity Advantage |
$14.92
|
| Rate for Payer: Cofinity Advantage |
$380.62
|
| Rate for Payer: Cofinity Advantage |
$10.98
|
| Rate for Payer: Cofinity Commercial |
$413.88
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$17.99
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$467.62
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$78.69
|
| Rate for Payer: Cofinity Commercial |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$17.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$489.38
|
| Rate for Payer: Healthscope Commercial |
$16.44
|
| Rate for Payer: Healthscope Commercial |
$16.72
|
| Rate for Payer: Healthscope Commercial |
$433.12
|
| Rate for Payer: Healthscope Commercial |
$19.19
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$18.49
|
| Rate for Payer: Healthscope Commercial |
$82.35
|
| Rate for Payer: Healthscope Commercial |
$18.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$462.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.94
|
| Rate for Payer: PHP Commercial |
$15.53
|
| Rate for Payer: PHP Commercial |
$17.46
|
| Rate for Payer: PHP Commercial |
$462.19
|
| Rate for Payer: PHP Commercial |
$17.78
|
| Rate for Payer: PHP Commercial |
$18.12
|
| Rate for Payer: PHP Commercial |
$409.06
|
| Rate for Payer: PHP Commercial |
$77.78
|
| Rate for Payer: PHP Commercial |
$15.79
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: Priority Health SBD |
$13.43
|
| Rate for Payer: Priority Health SBD |
$13.18
|
| Rate for Payer: Priority Health SBD |
$57.65
|
| Rate for Payer: Priority Health SBD |
$303.19
|
| Rate for Payer: Priority Health SBD |
$11.51
|
| Rate for Payer: Priority Health SBD |
$9.88
|
| Rate for Payer: Priority Health SBD |
$342.56
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: Priority Health SBD |
$12.94
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$8.18
|
| Rate for Payer: UMR Bronson Commercial |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.04
|
| Rate for Payer: UMR Bronson Commercial |
$211.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$40.26
|
| Rate for Payer: UMR Bronson Commercial |
$8.04
|
| Rate for Payer: UMR Bronson Commercial |
$239.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.62
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION (TPN COMPONENT)
|
Facility
|
OP
|
$762.50
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
300444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$686.25 |
| Rate for Payer: Aetna American Axle |
$495.62
|
| Rate for Payer: Aetna Commercial |
$648.12
|
| Rate for Payer: Aetna Medicare |
$381.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.62
|
| Rate for Payer: BCBS Complete |
$305.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cofinity Advantage |
$533.75
|
| Rate for Payer: Cofinity Commercial |
$655.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.00
|
| Rate for Payer: Healthscope Commercial |
$686.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$533.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.88
|
| Rate for Payer: PHP Commercial |
$648.12
|
| Rate for Payer: Priority Health SBD |
$480.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UMR Bronson Commercial |
$282.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.88
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION (TPN COMPONENT)
|
Facility
|
IP
|
$762.50
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
300444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$335.50 |
| Max. Negotiated Rate |
$686.25 |
| Rate for Payer: Aetna American Axle |
$495.62
|
| Rate for Payer: Aetna Commercial |
$648.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.62
|
| Rate for Payer: Cash Price |
$610.00
|
| Rate for Payer: Cofinity Advantage |
$533.75
|
| Rate for Payer: Cofinity Commercial |
$655.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.00
|
| Rate for Payer: Healthscope Commercial |
$686.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$533.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.88
|
| Rate for Payer: PHP Commercial |
$648.12
|
| Rate for Payer: Priority Health SBD |
$480.38
|
| Rate for Payer: UMR Bronson Commercial |
$335.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.88
|
|
|
POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 00338067504
|
| Hospital Charge Code |
9807
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.10
|
| Rate for Payer: UHC Core |
$24.93
|
| Rate for Payer: UHC Exchange |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 00338067504
|
| Hospital Charge Code |
9807
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ CAPSULE,EXTENDED RELEASE
|
Facility
|
OP
|
$3.72
|
|
|
Service Code
|
NDC 60687065311
|
| Hospital Charge Code |
13644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$3.35 |
| Rate for Payer: Aetna American Axle |
$2.42
|
| Rate for Payer: Aetna Commercial |
$3.16
|
| Rate for Payer: Aetna Medicare |
$1.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.42
|
| Rate for Payer: BCBS Complete |
$1.49
|
| Rate for Payer: Cash Price |
$2.98
|
| Rate for Payer: Cofinity Advantage |
$2.60
|
| Rate for Payer: Cofinity Commercial |
$3.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.98
|
| Rate for Payer: Healthscope Commercial |
$3.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.79
|
| Rate for Payer: PHP Commercial |
$3.16
|
| Rate for Payer: Priority Health SBD |
$2.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.42
|
| Rate for Payer: UHC Core |
$1.94
|
| Rate for Payer: UHC Exchange |
$1.46
|
| Rate for Payer: UMR Bronson Commercial |
$1.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.79
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ CAPSULE,EXTENDED RELEASE
|
Facility
|
OP
|
$74.02
|
|
|
Service Code
|
NDC 60687065321
|
| Hospital Charge Code |
13644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.39 |
| Max. Negotiated Rate |
$66.62 |
| Rate for Payer: Aetna American Axle |
$48.11
|
| Rate for Payer: Aetna Commercial |
$62.92
|
| Rate for Payer: Aetna Medicare |
$37.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.11
|
| Rate for Payer: BCBS Complete |
$29.61
|
| Rate for Payer: Cash Price |
$59.22
|
| Rate for Payer: Cofinity Advantage |
$51.81
|
| Rate for Payer: Cofinity Commercial |
$63.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.22
|
| Rate for Payer: Healthscope Commercial |
$66.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.52
|
| Rate for Payer: PHP Commercial |
$62.92
|
| Rate for Payer: Priority Health SBD |
$46.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.11
|
| Rate for Payer: UHC Core |
$38.56
|
| Rate for Payer: UHC Exchange |
$29.09
|
| Rate for Payer: UMR Bronson Commercial |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.52
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$227.05
|
|
|
Service Code
|
NDC 00904721661
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.01 |
| Max. Negotiated Rate |
$204.34 |
| Rate for Payer: Aetna American Axle |
$147.58
|
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: Aetna Medicare |
$113.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.58
|
| Rate for Payer: BCBS Complete |
$90.82
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cofinity Advantage |
$158.94
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.29
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: Priority Health SBD |
$143.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.58
|
| Rate for Payer: UHC Core |
$118.29
|
| Rate for Payer: UHC Exchange |
$89.23
|
| Rate for Payer: UMR Bronson Commercial |
$84.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.66
|
|
|
Service Code
|
NDC 00245531689
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$2.39 |
| Rate for Payer: Aetna American Axle |
$1.73
|
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna Medicare |
$1.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.73
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cofinity Advantage |
$1.86
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: Priority Health SBD |
$1.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.73
|
| Rate for Payer: UHC Core |
$1.39
|
| Rate for Payer: UHC Exchange |
$1.05
|
| Rate for Payer: UMR Bronson Commercial |
$0.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$988.00
|
|
|
Service Code
|
NDC 24979023102
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$365.56 |
| Max. Negotiated Rate |
$889.20 |
| Rate for Payer: Aetna American Axle |
$642.20
|
| Rate for Payer: Aetna Commercial |
$839.80
|
| Rate for Payer: Aetna Medicare |
$494.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.20
|
| Rate for Payer: BCBS Complete |
$395.20
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Advantage |
$691.60
|
| Rate for Payer: Cofinity Commercial |
$849.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.40
|
| Rate for Payer: Healthscope Commercial |
$889.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$790.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.00
|
| Rate for Payer: PHP Commercial |
$839.80
|
| Rate for Payer: Priority Health SBD |
$622.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.20
|
| Rate for Payer: UHC Core |
$514.75
|
| Rate for Payer: UHC Exchange |
$388.28
|
| Rate for Payer: UMR Bronson Commercial |
$365.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$265.55
|
|
|
Service Code
|
NDC 00245531601
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$116.84 |
| Max. Negotiated Rate |
$239.00 |
| Rate for Payer: Aetna American Axle |
$172.61
|
| Rate for Payer: Aetna Commercial |
$225.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.61
|
| Rate for Payer: Cash Price |
$212.44
|
| Rate for Payer: Cofinity Advantage |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$228.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.44
|
| Rate for Payer: Healthscope Commercial |
$239.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.16
|
| Rate for Payer: PHP Commercial |
$225.72
|
| Rate for Payer: Priority Health SBD |
$167.30
|
| Rate for Payer: UMR Bronson Commercial |
$116.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.16
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$439.45
|
|
|
Service Code
|
NDC 00074780413
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Advantage |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UMR Bronson Commercial |
$193.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$258.50
|
|
|
Service Code
|
NDC 24979023001
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$232.65 |
| Rate for Payer: Aetna American Axle |
$168.03
|
| Rate for Payer: Aetna Commercial |
$219.72
|
| Rate for Payer: Aetna Medicare |
$129.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.03
|
| Rate for Payer: BCBS Complete |
$103.40
|
| Rate for Payer: Cash Price |
$206.80
|
| Rate for Payer: Cofinity Advantage |
$180.95
|
| Rate for Payer: Cofinity Commercial |
$222.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.80
|
| Rate for Payer: Healthscope Commercial |
$232.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.88
|
| Rate for Payer: PHP Commercial |
$219.72
|
| Rate for Payer: Priority Health SBD |
$162.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.03
|
| Rate for Payer: UHC Core |
$134.68
|
| Rate for Payer: UHC Exchange |
$101.59
|
| Rate for Payer: UMR Bronson Commercial |
$95.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.88
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$227.05
|
|
|
Service Code
|
NDC 00904721661
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.90 |
| Max. Negotiated Rate |
$204.34 |
| Rate for Payer: Aetna American Axle |
$147.58
|
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.58
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cofinity Advantage |
$158.94
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.29
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: Priority Health SBD |
$143.04
|
| Rate for Payer: UMR Bronson Commercial |
$99.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2,561.50
|
|
|
Service Code
|
NDC 00832532310
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,127.06 |
| Max. Negotiated Rate |
$2,305.35 |
| Rate for Payer: Aetna American Axle |
$1,664.97
|
| Rate for Payer: Aetna Commercial |
$2,177.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.97
|
| Rate for Payer: Cash Price |
$2,049.20
|
| Rate for Payer: Cofinity Advantage |
$1,793.05
|
| Rate for Payer: Cofinity Commercial |
$2,202.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,049.20
|
| Rate for Payer: Healthscope Commercial |
$2,305.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,793.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,921.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,177.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,921.12
|
| Rate for Payer: PHP Commercial |
$2,177.28
|
| Rate for Payer: Priority Health SBD |
$1,613.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,127.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,921.12
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$286.90
|
|
|
Service Code
|
NDC 00574027511
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.24 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna American Axle |
$186.49
|
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.49
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Advantage |
$200.83
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: Priority Health SBD |
$180.75
|
| Rate for Payer: UMR Bronson Commercial |
$126.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$439.45
|
|
|
Service Code
|
NDC 00074780413
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna Medicare |
$219.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: BCBS Complete |
$175.78
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Advantage |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.64
|
| Rate for Payer: UHC Core |
$228.95
|
| Rate for Payer: UHC Exchange |
$172.70
|
| Rate for Payer: UMR Bronson Commercial |
$162.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.87
|
|
|
Service Code
|
NDC 00574027500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna American Axle |
$1.87
|
| Rate for Payer: Aetna Commercial |
$2.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.87
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Advantage |
$2.01
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Healthscope Commercial |
$2.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: PHP Commercial |
$2.44
|
| Rate for Payer: Priority Health SBD |
$1.81
|
| Rate for Payer: UMR Bronson Commercial |
$1.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.15
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.66
|
|
|
Service Code
|
NDC 00245531689
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.39 |
| Rate for Payer: Aetna American Axle |
$1.73
|
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.73
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cofinity Advantage |
$1.86
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: Priority Health SBD |
$1.68
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$265.55
|
|
|
Service Code
|
NDC 00245531601
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.25 |
| Max. Negotiated Rate |
$239.00 |
| Rate for Payer: Aetna American Axle |
$172.61
|
| Rate for Payer: Aetna Commercial |
$225.72
|
| Rate for Payer: Aetna Medicare |
$132.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.61
|
| Rate for Payer: BCBS Complete |
$106.22
|
| Rate for Payer: Cash Price |
$212.44
|
| Rate for Payer: Cofinity Advantage |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$228.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.44
|
| Rate for Payer: Healthscope Commercial |
$239.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.16
|
| Rate for Payer: PHP Commercial |
$225.72
|
| Rate for Payer: Priority Health SBD |
$167.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.61
|
| Rate for Payer: UHC Core |
$138.35
|
| Rate for Payer: UHC Exchange |
$104.36
|
| Rate for Payer: UMR Bronson Commercial |
$98.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.16
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$399.95
|
|
|
Service Code
|
NDC 00574027501
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.98 |
| Max. Negotiated Rate |
$359.95 |
| Rate for Payer: Aetna American Axle |
$259.97
|
| Rate for Payer: Aetna Commercial |
$339.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.97
|
| Rate for Payer: Cash Price |
$319.96
|
| Rate for Payer: Cofinity Advantage |
$279.96
|
| Rate for Payer: Cofinity Commercial |
$343.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.96
|
| Rate for Payer: Healthscope Commercial |
$359.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$279.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.96
|
| Rate for Payer: PHP Commercial |
$339.96
|
| Rate for Payer: Priority Health SBD |
$251.97
|
| Rate for Payer: UMR Bronson Commercial |
$175.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.96
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$988.00
|
|
|
Service Code
|
NDC 24979023102
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$434.72 |
| Max. Negotiated Rate |
$889.20 |
| Rate for Payer: Aetna American Axle |
$642.20
|
| Rate for Payer: Aetna Commercial |
$839.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.20
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Advantage |
$691.60
|
| Rate for Payer: Cofinity Commercial |
$849.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.40
|
| Rate for Payer: Healthscope Commercial |
$889.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.00
|
| Rate for Payer: PHP Commercial |
$839.80
|
| Rate for Payer: Priority Health SBD |
$622.44
|
| Rate for Payer: UMR Bronson Commercial |
$434.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$260.85
|
|
|
Service Code
|
NDC 00832532311
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.51 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna American Axle |
$169.55
|
| Rate for Payer: Aetna Commercial |
$221.72
|
| Rate for Payer: Aetna Medicare |
$130.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.55
|
| Rate for Payer: BCBS Complete |
$104.34
|
| Rate for Payer: Cash Price |
$208.68
|
| Rate for Payer: Cofinity Advantage |
$182.59
|
| Rate for Payer: Cofinity Commercial |
$224.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.68
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.64
|
| Rate for Payer: PHP Commercial |
$221.72
|
| Rate for Payer: Priority Health SBD |
$164.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.55
|
| Rate for Payer: UHC Core |
$135.90
|
| Rate for Payer: UHC Exchange |
$102.51
|
| Rate for Payer: UMR Bronson Commercial |
$96.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.64
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$284.35
|
|
|
Service Code
|
NDC 72888007501
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.11 |
| Max. Negotiated Rate |
$255.91 |
| Rate for Payer: Aetna American Axle |
$184.83
|
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.83
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Advantage |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Healthscope Commercial |
$255.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.26
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: Priority Health SBD |
$179.14
|
| Rate for Payer: UMR Bronson Commercial |
$125.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$260.85
|
|
|
Service Code
|
NDC 00832532311
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.77 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna American Axle |
$169.55
|
| Rate for Payer: Aetna Commercial |
$221.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.55
|
| Rate for Payer: Cash Price |
$208.68
|
| Rate for Payer: Cofinity Advantage |
$182.59
|
| Rate for Payer: Cofinity Commercial |
$224.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.68
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.64
|
| Rate for Payer: PHP Commercial |
$221.72
|
| Rate for Payer: Priority Health SBD |
$164.34
|
| Rate for Payer: UMR Bronson Commercial |
$114.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.64
|
|
